A cohort study of the effect of Streptococcus agalactiae on milk yield and somatic cell count in Norwegian dairy cows

The primary objective of the present study was to estimate the effect of Streptococcus agalactiae intramammary infection on milk production and somatic cell count (SCC) in Norwegian dairy cows. A secondary objective was to assess differences in the effect of common Strep. agalactiae sequence types (ST) found in Norwegian dairy herds. We performed a cohort study combining registry data with sequence-type data from Strep. agalactiae isolates. Herds in which Strep. agalactiae had been detected in individual animals (bacteriological culture or quantitative PCR) between 2012 and 2015 were included. We accessed monthly test-day milk yield records for the entire period to compare milk yield and SCC between cows that were Strep. agalactiae positive and all other cows, within each herd. The study sample consisted of 150 herds, 15,757 cows, 30,850 lactations, and 204,126 test days. We evaluated the effects of Strep. agalactiae on test-day milk yield and SCC using mixed linear regression models, controlling for clustering by herd, cow, and lactation. Multilocus sequence typing of Strep. agalactiae was available for isolates from 86 herds. Additional models were fit to a subset of herds (n = 59) in which ST1, ST23, ST103, and ST196 had been found, to compare the effects of ST on milk production and SCC. In the period 3 to 2 mo before diagnosis, Strep. agalactiae-positive cows produced an average of 1.3 kg more DIM-adjusted milk/d than their negative herd mates. At the time of diagnosis, production was on average 0.13 kg less DIM-adjusted milk/d in Strep. agalactiae-positive cows than in negative cows; 2 to 3 mo after diagnosis, they produced 1.24 kg less DIM-adjusted milk/d than negative cows. Losses persisted for the rest of the investigated period. Cows with ST23, ST103, and ST196 followed a similar pattern as the overall analysis with respect to milk production, whereas ST1-affected cows produced similar amounts of milk before diagnosis as the negative cows. Cows with ST1 experienced the largest milk loss 1 to 2 mo after diagnosis but then recovered to some extent; for cows with ST103, the severe milk loss persisted for the rest of the investigation period. The cow-associated ST103 elicited a lower response in peak SCC compared with ST23, ST103, and ST196. The results indicate an effect of Strep. agalactiae on milk production and SCC. Production was lowest 2 to 3 mo after a positive sample. Peak SCC was reached the month before diagnosis, with notable differences between sequence types.     

Prospective study of the risk of Clostridium difficile diarrhoea in elderly patients following treatment with cefotaxime or piperacillin-tazobactam

BACKGROUND: Rates of Clostridium difficile diarrhoea have recently been rising, with the elderly being at highest risk. AIM: To compare the incidence of C. difficile colonization and diarrhoea in elderly patients treated for presumed infection with either empirical cefotaxime (CTX) or piperacillin-tazobactam (PT). METHODS: A prospective, ward-based, crossover study was carried out on two well-matched care of the elderly wards at a UK tertiary care hospital, in patients requiring empirical broad-spectrum antibiotic treatment. RESULTS: There was a highly significant increased incidence of C. difficile colonization (26/34 vs. 3/14, P=0.001) and diarrhoea (18/34 vs. 1/14, P=0.006) in patients who received CTX as opposed to PT. DNA fingerprinting suggested that most infections arose from strains acquired from the hospital environment. CONCLUSIONS: Elderly patients are significantly less likely to develop C. difficile diarrhoea after treatment with PT than after CTX. The source of C. difficile appears to be predominantly from the ward environment.     

Spermicidal activity of oxovanadium(IV) complexes of 1, 10-phenanthroline, 2,2'-bipyridyl, 5'-bromo-2'-hydroxyacetophenone and derivatives in humans

We have recently reported that tetrahedral metallocene complexes containing vanadium(IV) (vanadocene) have potent spermicidal activity against human sperm. The spermicidal activity was dependent on vanadium(IV) as the central metal ion within the bis-cyclopentadienyl (Cp2)-metal complex, but the variation of diacido groups and/or replacement with bidentate ligands coordinated to the Cp2-vanadium(IV) moiety also significantly modulated the spermicidal potency. To assess the structure-activity relationship between vanadocenes and other coordination complexes of vanadium(IV), a set of 11 oxovanadium(IV) complexes with different geometrical configurations were synthesized and evaluated for spermicidal activity by computer-assisted sperm analysis. These complexes included mono and bis ancillary ligands, 1,10-phenanthroline (phen): [VO(phen), VO(phen)2, VO(Me2-phen), VO(Me2-phen)2, VO(Cl-phen), and VO(Cl-phen)2]; 2,2'-bipyridyl (bipy): [VO(bipy), VO(bipy)2, VO(Me2-bipy), and VO(Me2-bipy)2], linked via nitrogen atoms; and 5'-bromo-2'-hydroxyacetophenone (acph): [VO(Br,OH-acph)2], linked via oxygen donor atoms. All 11 oxovanadium(IV) complexes elicited concentration-dependent spermicidal activity at micromolar concentrations (EC50 values: 5.5-118 microM). The bis-phenanthroline complex of oxovanadium(IV), VO(Cl-phen)2, was the most active, and the mono bipyridyl complex, VO(bipy), was the least active; the order of efficacy was VO(Cl-phen)2 > VO(phen)2 > VO(Br,OH-acph)2 > VO(Me2-phen) > VO(bipy)2 > VO(phen) > VO(Cl-phen) > VO(Me2-phen)2 > VO(Me2-bipy)2 > VO(Me2-bipy) > VO(bipy). The neutral complex, VO(Br, OH-acph)2, induced rapid sperm immobilization (T1/2 = 38 sec). The sperm-immobilizing activity of mono- and bis-ligated oxovanadium(IV) complexes was irreversible, since the treated sperm underwent apoptosis, as determined by the flow cytometric quantitation of mitochondrial membrane potential, surface Annexin V binding assay, and in situ DNA nick-end labeling of sperm nuclei. The percentages of apoptotic sperm quantitated by the flow cytometric assay correlated well with the spermicidal potency of oxovanadium(IV) complexes. These results provide unprecedented evidence that the spermicidal and apoptosis-inducing activities of vanadium(IV) complexes are determined by the oxidation state of vanadium as well as their geometry. Because of its rapid and potent sperm-immobilizing activity, the bromo-hydroxyacetophenone complex, [VO(Br,OH-acph)2], may be useful as a contraceptive agent.     

Predicting psychiatric admission from an emergency room. Psychiatric, psychosocial, and methodological factors

The determinants of psychiatric hospitalization, especially nonspecific issues, have been studied extensively. The methodological problem of correlational non-cross-validated findings are seen as contributing to our uncertainties about the critical issues involved in the decision to admit. A cross-validated multiple regression analysis of determinants of hospitalization in an inner-city municipal hospital revealed two determinants of hospitalization: severity of schizophrenic symptoms and active suicidal and/or homicidal ideation. They accounted for one third of the variance without shrinkage. Quasi-experimental designs may be the most efficient means of studying the remaining unexplained variance.     

Fat cell number and weight gain in lithium treated patients

Total amount of fat, fat cell size, and fat cell number were determined in 33 patients under long-term lithium treatment. The weight gain during the treatment was estimated both by the patients themselves (questionnaire) and from their records. A positive correlation between fat cell number and weight gain was found whereas the fat cell size showed no correlation to weight gain.     

Lithium effects on diurnal rhythm of calcium, magnesium, and phosphate metabolism in manic-melancholic disorder

The diurnal rhythm of plasma phosphate, calcium, and magnesium was studied in 34 lithium treated patients, in 42 other psychiatric patients, and in 47 healthy persons. Seventeen blood samples were drawn from each person during the 24-hour period. Lithium was given at 10 p.m. and in the next few hours plasma phosphate decreased compared with the two control groups. In the same period plasma calcium showed a temporary increase, whereas plasma magnesium was increased during the whole 24-hour period. The lithium treated patients had a reduced urinary calcium excretion during the night, and an increased urinary magnesium excretion during the day, whereas no changes were found in urinary phosphate excretion.     

Determinants of antimicrobial treatment for udder health in Danish dairy cattle herds

Societal pressure to limit the use of antibiotics in livestock production systems, including dairy cattle systems, is consistently increasing. To motivate farmers to reduce antibiotic usage, it is important to understand the factors that determine whether a cow will be treated with antibiotics or not. If farmers' usual practices regarding antibiotic treatments are taken into account, they may be motivated to adopt control measures that can facilitate prudent use of antibiotics and are at the same time cost-effective. In this study, we analyzed database recordings of milk yield and somatic cell count from the routine milk recording scheme, clinical registrations of mastitis and PCR results, and cow factors such as days in milk and parity in relation to antibiotic treatments for 518 dairy herds in Denmark. Farm-wise logistic regressions were used to predict antimicrobial treatment based on these factors. The resulting regression coefficients of 422 herds were further analyzed by principal component analysis and clustering to determine the driving predictors for treatment in different groups of farms. The results showed that determinants that were most important for predicting antibiotic treatments vary from one farm to another. Health indicators such as PCR or somatic cell count were most indicative for treatment on some farms, whereas other groups seemed to depend more on production factors (milk yield) or later culling of the cows. This shows that farmers behave differently and differences can be identified in register data. This information can be considered when developing cost-effective herd-specific control measures of mastitis to promote prudent use of antibiotics in Danish dairy cattle farms.     

Economic and epidemiological impact of different intervention strategies for clinical contagious mastitis

The overall aim of this study was to compare different intervention strategies for clinical intramammary infections (IMI). We conducted a simulation study to represent a Danish dairy cattle herd with IMI caused mostly by Staphylococcus aureus and 9 different intervention strategies for clinical IMI. A standard intervention of 3 d of treatment consisting of intramammary injections for all clinical cases was used. Two of the strategies reflected the use of more antibiotics and 6 strategies reflected cow-specific treatment or culling decisions. For these strategies, we assessed the cost and effectiveness of culling as an IMI intervention. Our results showed that nearly all strategies could reduce the number of IMI cases [e.g., a median of 37 clinical cases with the extended intramammary treatment over 5 d strategy (Basic5) and 30 clinical cases with the cow culled with recovery probability below 50% (Before50)] compared with the standard intervention (median of 42 clinical cases). This happened alongside either increased antibiotic usage (e.g., from a median of 123 treatment days up to 179 treatment days with strategy Basic5) or an increased number of cows culled in relation to IMI (e.g., from a median of 16 up to 24 cows with strategy Before50). Strategies with more antibiotics or reactive culling had a slightly higher net income (e.g., €190,014 median net income with strategy Basic5 or €196,995 with strategy Before50 compared with €187,666 with the standard strategy). This shows that a cow-specific clinical intervention approach can be cost-effective in reducing IMI incidence.